"We've kicked Vietnam syndrome!" exulted President Bush in 1991, referring to
American malaise after the disaster of Vietnam. But although most of its
symptoms emerged later, the Persian Gulf conflict clearly marked the beginning
of an unexplained illness that has been named Gulf War syndrome. In the
summer of 1991, Brian Martin returned from Iraq to his family in Niles,
Michigan. He was happy to be home but had a mysterious rash that wouldn't go
away. During the next months other symptoms followed--memory lapses, mood
swings, and finally debilitating fatigue. He can't work and gets some
disability pay from the VA. But even worse symptoms have afflicted Brian's
family. His son Deven, conceived shortly after Brian's return, was born with
acute respiratory problems and an umbilical cord five feet long. His
twenty-five-year-old wife, Kim, has suffered from seemingly unrelated and
unconfirmed complaints--rashes, headaches, breast lumps, ovarian cysts, a
thinning skull, and unexplained cervical infections. Now the Martins no longer
have sex; after intercourse, Kim experiences cramps and a burning sensation:
when her husband's semen touches her skin, she told Redbook, it feels
"like it was on fire."1 Doctors have been unable to find organic causes for
any of the Martin's problems.

In Barrington, Illinois, the Albuck family is also suffering. Gulf War veteran
Troy has fatigue, muscle soreness, swollen joints, and headaches, diarrhea, and
bleeding gums. His wife, Kelli has hearing problems, migraines, and attacks of
pelvic inflammatory disease. She reports that her husband's semen is a toxic
substance that "causes sores--blisters which actually open and bleed." Worst
of all, their son Alex was born prematurely in 1993 with a rare blood infection
and now has cerebral palsy. When he was born, he had a rash that looked like
the ones Troy
and Kelli have had. Journalist David France declares that "doctors have been
unable to explain their cause, give a diagnosis, or prescribe a remedy."2

In Yorkshire, England, Robert Lake's marriage has broken up since
he returned from the Persian Gulf, plagued by headaches, vomiting, and
diarrhea. Lake had become an army apprentice at sixteen and trained in
Cyprus and Germany, where he moved at nineteen. Serving as a radar
technician in the Gulf, he was shocked and frightened. On return, he
began to have violent mood swings and nightmares of running away
from an enemy; he made two suicide attempts and spent two months in
psychiatric hospitals, where he was treated for PTSD. He continued to
have angry outbursts, his German wife left him, and the army discharged him in
1993. Lake has lost about seventy pounds and has been
diagnosed with anorexia nervosa. But he believes that his symptoms
come from anthrax inoculations and anti nerve gas tablets he took in the
Gulf. "I am angry and disappointed," he told The Guardian, "that the
MOD [Ministry of Defense] are so pig ignorant and uncaring."3

The Martins, the Albucks, and Robert Lake are among the thousands of American
and British victims of what is called Gulf War syndrome (GWS), Saudi flu, or
desert fever. Of the 697,000 U.S. troops who served in the Gulf, 60,000 have
reported ailments from memory loss to cancer. The numbers in England are much
smaller: 567 veterans, out of 45,000 British personnel, are seeking
compensation or disability payments. Veterans' complaints include chronic
fatigue, diarrhea, aches and pains, headaches, hair loss, bleeding gums,
irritability, insomnia, muscle spasms, and night sweats. Two veterans in
Mississippi have claimed to be shrinking.4 Among physicians, politicians,
journalists, and veterans who believe that Gulf War syndrome is a new and
unique illness, ideas about its cause vary. Many believe that it is contagious
and can be passed through sex, sweat, or the air.

Like CFS patients, Gulf War veterans have organized self-help networks. In 1994
David France reported in Redbook that "many vets rely on an informal
word-of-mouth network to track the illness, tally developments, or find
solace."5 Veterans and their families who live on military bases trade stories,
and electronic networks of Gulf War vets are humming; the Internet has hugely
expanded opportunities to communicate. Most veterans and their families react
angrily to the idea that they are suffering from post-traumatic stress
disorder. Willie Hicks, a black veteran from Alabama, told Esquire
journalist Gregory Jaynes, "Shit, I don't sleep more than two, three hours
a day. Anxiety.... Couldn't get along with nobody.... Couldn't even get out the
house.... Post-traumatic stress, my black ass."6 Carole Hill, an English nurse
who began to feel tired six months after her husband returned to Cheshire from
the Gulf, insists: "This can't be psychological. I've spoken to too many
veterans whose families are suffering similar symptoms."7

GWS patients in England and the U.S. are convinced that the cause of their
medical problems lies in their exposure to chemicals and drugs in the Gulf, and
that their governments are conspiring to deprive them of health benefits and
disability pay. Hicks says angrily, "Some of us bleed from the penis. Bleed all
over the sheets. Government won't even pay for the sheets."8 "We believe
there's a cover-up," British-born Texan Vic Silvester tells The Guardian
9."I was a volunteer, so I have to take whatever I get," one American
veteran says. "But my boy and my wife? They did not volunteer, they did not
take my oath. They've been drafted against their will and they've got wounds
from battle."10 A group of sick wives in Texas has started its own secret
research initiative--"secret," according to one of them, "because they fear the
military might try to block their study for reasons she can only guess at."11

In fact, American government reactions to Gulf War syndrome have been concerned
and sympathetic. No elected politician wants to risk his constituents' anger.
The Clinton administration, mindful of alienation over Vietnam and the Agent
Orange fiasco, has moved very carefully. President Clinton authorized a
scientific advisory panel to investigate the symptoms. Hillary Rodham Clinton
has come out as a "friend of Gulf War syndrome sufferers." At the opening
session of the Presidential Committee meeting, she said, "Just as we relied on
our troops when they were sent to war, we must assure them that they can rely
on us now."12 Politicians agree that Persian Gulf veterans deserve respect,
attention, and full support, and no decent citizen could object to the research
efforts and investigations funded by the government. Since 1994, the government
has authorized disability payments for veterans with GWS.

The respectful and cautious responses of the U.S. government, however, have
reinforced the suspicion that Gulf War syndrome is a unique disease and fed
anxieties and conspiracy rumors about it. Dissenting views have been silenced;
when Dr. Edward Young, chief of staff at the Houston VA Medical Center,
announced, "There's been mass hallucinations. There's been mass post-traumatic
stress disorder" and attributed some of the epidemic to frustration and anger,
he was suspended by his boss, Jesse Brown, secretary of the Department of
Veterans'Affairs.13 But more skeptical responses of the British Defense
Ministry have not quelled protests from MPS or veterans either.

The extraordinary conditions of the Gulf War--and Iraq's admission that they
had biological weapons they didn't use have added to
suspicions that GWS is caused by a toxic agent. These concerns and
questions reappeared when the Pentagon announced in June 1996 that
a weapons storage area exploded by American troops contained toxic
gases. But there is no clinical evidence that GWS soldiers were exposed
to the blast nor that the minute traces of sarin and mustard gas could
have caused the enormous variety of symptoms being reported by
thousands of veterans five years later. In a "Sixty Minutes" special on
August 25, 1996, a group of soldiers from the 37th Engineers Batallion
who participated in blowing up an Iraqi arsenal near Kamisayah in
March 1991 described their fears at the time of the demolition, and a
variety of symptoms since. But CBS did not interview any doctors, specialists
in the effects of nerve gas, or Pentagon officials who could support the claim
that this chemical exposure could lead to fatigue, gastrointestinal symptoms,
and other problems. What has seemed likely all along is that no one incident,
toxin, virus, or disease entity is responsible for all the complaints that have
been collected under the heading
of Gulf War syndrome. 14

Meanwhile doctors are pursuing many other explanations. Dr. Edward Hyman of New
Orleans, who believes the syndrome is an arterial infection passed through the
air like tuberculosis, has been voted $1.2 million by Congress for research.15
Ross Perot is among those funding a Mayo Clinic project. Dr. Boaz Milner in
Allen Park, Michigan, has treated more than three hundred GWS patients. He has
suggested at least five possible causes for Gulf War syndrome: radiation
poisoning, effects of experimental medicines, environmental contaminants,
chemical compounds, and Iraq's biological arsenal. Dr. Eula Bingham, a
professor of environmental health at the University of Cincinnati, suspects
leishmaniasis, a parasitic infection caused by sand fly bites; but the Armed
Forces Epidemiological Board says no. Researchers at Duke have found that the
experimental nerve gas pill pyrodostigmine bromide, used in combination with
pesticides, caused neurological problems in chickens. When Dr. Stephen C.
Joseph, assistant secretary of defense for health affairs, responded that
pyrodostigmine stays in the human body for only a few hours, the next
suggestion was multiple chemical sensitivity. One entomologist reported that an
insect repellent used by 40 percent of the soldiers in the Gulf becomes more
toxic when mixed with pyrodostigmine.16 Among the latest stories is that
aspartame, an artificial sweetener used in Nutrasweet, is linked to GWS. Now
that Hillary Johnson and others are pointing out correspondences with chronic
fatigue syndrome, researchers are investigating retroviruses.

Yet government investigations have produced no evidence of anorganic
syndrome. Dr. Francis Murphy, acting director of the office of environmental
medicine and public health at the VA says, "We have found nothing in our
investigations that we consider transmissible. We've found no clear-cut
evidence that this is being transmitted either casually or sexually."17 A
defense department study of more than a thousand ailing veterans indicated that
60 percent had organic ailments with known causes, which were not
disproportionate to their random occurrence in the population. Another 25
percent had psychological disturbances, including depression and post-traumatic
stress disorder. About 15 percent had unexplained ailments, including
headache, memory loss, fatigue, sleep problems, and intestinal and respiratory
complaints.18 In January 1995, a panel affiliated with the National Academy of
Sciences recommended a fuller and more coordinated study of the problem.19 By
April 1996, the results were announced: conducted at a cost of $80 million, the
survey of 18,924 veterans found "no single cause or mystery ailment to support
suspicions about the existence of a gulf war syndrome."20

In England, results were similar. "I have seen or heard nothing that makes me
believe there is a specific syndrome directly attributable to the gulf war,"
says surgeon-general Tony Revell. A Ministry of Defense study indicated that
about 52 percent of those surveyed had minor ailments like asthma. Fourteen
percent had more serious disorders, including leukemia and kidney disease.
Solicitor Hilary Meredith, whose law firm represents 567 veterans, say nine
have died from cancer. Twenty-two percent had post-traumatic stress disorder,
and 14 percent had other psychological symptoms, including depression and
anxiety.21 In July 1995, the Royal College of Physicians gave its official
backing for further investigations, although a preliminary study had concluded
that "there was no single cause for the variety of illnesses suffered by the
servicemen and women who have been examined."22

Many of these symptoms sound like war neurosis, shell shock, or
post-traumatic stress disorder. Despite the rapidity with which PTSD has
entered the language, most people do not understand what it means or know about
its long history: from the Civil War on, battle fatigue, shell shock, combat
neurosis, or PTSD has been observed, studied, and documented, not only in
American medicine and psychiatry but around the world.

Since the Gulf War, however, journalists, doctors, government officials, and
psychologists have been surprisingly silent about PTSD. Instead, the media have
exacerbated fears of Gulf War symptoms. By the summer of 1995, more than two
hundred newspaper stories about Gulf War syndrome had appeared in England.23
Even Doonesbury picked up on the controversy, with B.D. complaining to
Boopsie about his symptoms and denying that they could be caused by stress:
"It doesn't explain why this thing is showing up in family members too! I'm
terrified I might end up passing it on to you!"

In the United States, both conservative and liberal journalists have long
promoted the idea that Gulf War syndrome is a contagious disease being covered
up by the government. In Redbook David France asks why the VA has not
authorized semen tests on veterans. In the feminist Women's Review of Books,
Laura Flanders writes, "Today many women who served in the Gulf are still
in combat, only this time their fight is with the Department of Defense and the
Veterans Administration.... After months of struggle and increasing sickness,
the tears are now of rage."24 Flanders has also written about GWS for The
Nation, where she declares that "fears are growing about just how
contagious Gulf War Syndrome may be. Outgoing Senator Donald Riegel conducted a
study of 1,200 sick male veterans last year and found that 78 percent of their
wives had been affected.... Penny Larrissey, a veteran's wife who told me last
year that during intercourse her husband's semen burns, has been in touch with
military wives around the country who report not just discomfort but terrible
vaginal infections, cysts, blisters and even bleeding sores. Most military
family members remain outside the national test samples. And some are invisible
altogether. Thanks to the Pentagon's devotion to discrimination, gay men and
lesbians whose partners are sick are too scared to ask for help and too
intimidated to tell."25

This kind of journalism makes classic history: scare headlines, vague
statistics, uncritical descriptions of "studies" and "reports," and the
extension of anxieties to gays in the military. Perceptions are reported as
facts; undifferentiated and unsubstantiated responses taken seriously as
medical evidence. Senator Riegel's staff, for example, surveyed six hundred
veterans, 77 percent of whom said that their spouses had some symptoms.
On the page opposite Flanders's story, an ad claims, "The most skeptical people
in America subscribe to The Nation." One has to wonder why.

Some of the most alarmist, upsetting, and irresponsible journalism has been
about birth defects related to GWS. Immediately after the war, there were
persistent rumors of birth defects among the families of returning veterans.
Laura Flanders notes dramatically that "freakish births are being reported
around the country and even internationally."26 In November 1995, Life
magazine published a special issue entitled "The Tiny Victims of Desert
Storm: Has Our Country Abandoned Them?" On the cover was a color picture of
Gulf War veteran Sgt. Paul Hanson and his three-year-old-son Jayce, born with
hands and feet attached to stumps. In the story, heart-rending photos of Jayce,
"the unofficial poster boy of the Gulf War babies," accompany text full of dire
warning and no firm medical or statistical evidence. "During the past year,"
the story says, "Life hasconducted its own inquiry into theplight of these children. We sought to learn whether U.S. policies put
them at risk, and whether the nation ought to be doing more for them and their
families."

The story describes the anguish of seven families whose children have birth
defects, from spinal bifida to mitral heart valve disorder. But reporters
Jimmie Briggs and Kenneth Miller do not provide numbers of complaints or
controls, although they sneer at "Pentagon bureaucrats" who claim that "at
least 3 percent of American babies are born with abnormalities." One activist
group, the Association of Birth Defect Children, has gathered data on ailing
babies born to 163 of the 970,000 who served in the Gulf War. According to
Life, "No one . . . knows how many babies have been born to Gulf vets,"
and "many still question whether Defense Department scientists are really
seeking the hard answers,"27 despite more than thirty studies of Gulf vets by
1995.

Esquire reported in 1994 that "of fifty-five children born to four
Guard Units in Mississippi thirty- seven are not normal."28 According to the
Mississippi Department of Public Health, however, two babies in these units
were born with severe defects and three with minor defects. The VA maintained
in May 1994 that the percentage of birth defects in the Mississippi units fell
within the normal range--a conclusion that "enraged" one mother, who argued
that birth defect statistics were not the point: "Our babies are sick all the
time. Why didn't they study our children's immune systems?" Dr. Alan Penman,
director of a study by the Centers for Disease Control and Prevention,
responded: "We don't believe that there's an excessively high rate of, common
illnesses in this group."29

Angry parents like Ammie West, whose daughter Reed was born with a chronic
respiratory infection, have condemned the Mississippi study, like other
government statistics and responses that offer facts and reassurance, as part
of a cover-up. A Pentagon survey of the army's six | largest military
installations showed that the rate of spontaneous abortion or miscarriage among
veterans' wives was about half the rate of society as a whole. But, says David
France, "This result has been denounced by vets as a partial finding at
best."30 Parents are understandably anxious and grief-stricken, but we have to
question the use" full of scare stories.

Journalists could be more helpful by reminding readers of the atmosphere
leading up to the Gulf War and the many forces that contributed to stress and
disorientation for participants. In a report of 10,020 Gulf War participants
issued in August 1995, the defense department announced, "Physical and
psychological stressors were major characteristics of the Persian Gulf. The
effect of both acute and chronic stress is a major etiologic consideration when
evaluating Persian Gulf veterans. U.S. troops entered a bleak, physically
demanding desert environment, where they were crowded into warehouses, storage
buildings, and tents with little personal privacy and few amenities. No one
knew that coalition forces eventually would win a quick war with relatively few
battle casualties. Consequently, most troops did not fight a 'four day war' but
spent months isolated in the desert, under constant stress, concerned about
their survival and their family's well-being a home, and uncertain about when
they would return home."31

In an article for the London Times, Dr. Simon Wessely reminds us just
how stressful service in the Persian Gulf was. Troops were afraid that Iraq
might use devastating chemical and biological weapons, and "to be ever alert
for a silent attack by nerve gas or invisible deadly microbes must have taken a
constant toll.... The situation was made worse by the cumbersome protection
suits, ill- adapted for the desert heat, that had to be worn as a
consequence."32

Testimony from Gulf War veterans with GWS confirms these descriptions.
Seventeen percent of Gulf War forces came from National Guard reserve units who
had never expected to be on active duty, especially under such ominous
conditions. They had heard about the ruthlessness of Saddam Hussein and his
unbeatable "elite Republican Guard. "That Saddam's troops proved to be
ill-equipped and outnumbered did not undo the months of fearful anticipation.
Iraqi Scud attacks on civilian populations intensified fears of a bestial
enemy, while propaganda about biological and chemical warfare made every new
experience potentially threatening. Soldiers also had to deal with frightening
gossip about the preventive medications offered to them.

One Hingham, Massachusetts, soldier, Larry McGinnis, took eight of the
anti-nerve gas pills--more than the recommended dose and vomited for several
hours. "Here we were," he told a reporter, "driving into Iraq with the 82nd
Airborne and me puking over the side into the sand.... I thought I was going to
die."33 McGinnis had reason to fear death. In his testimony to the House
Subcommittee of the Committee on Veterans'Affairs, he recalled crossing the DMI
"with the thought of the body bags and coffins that were being delivered....
But the one thought that kept coming back was Gas Chemical Warfare."34

Women too had profoundly disturbing combat experiences. Sergeant Carol Picou,
an army medical officer, drove a hospital truck into Iraq, where she saw
charred and smoldering bodies of animals and humans beside the highway.
Although Picou had seen burned bodies before, she was frightened: "These bodies
were different. They weren't normal." For two weeks Picou and her unit lived
near the battlefield, treating injured soldiers and Iraqi civilians from Basra.
After she returned from the Gulf, Picou began to suffer from muscle pain,
bladder problems, and memory loss. She is convinced that her symptoms were
caused not by horror, anxiety, and disgust but by the drug pyrodostigmine.35

Gulf War syndrome is shaping up to be a tragic standoff of men and women
suffering from the all-too-real after-effects of war, doctors unable to combat
the force of rumor and panic, and a government that feels the need to be
supportive of veterans. As Representative Joseph Kennedy told the House
Subcommittee, "They come back, were told when they begin to complain of various
illnesses that these can be explained through PTSD or through stress. It's one
thing for us to hear that. It's another thing, if you've got all these
sicknesses . . . and you are being told by a doctor that you go in to see at
the VA that, listen, there is nothing really wrong with you--all it is, you
know, you've got some psychological problem that is getting in your way--which
must be an enormous burden for these individuals to carry around.... Now if in
the end the conclusion is that these are illnesses that are explained only
through PTSD, that might be the conclusion but it seems to me that we are a
long way from drawing that conclusion at the moment."36

That was in the fall of 1992. Years have gone by, but each time the government
eliminates a chemical or bacterial cause, suspicion, resistance, and bitterness
grows. As Paul Cotton commented in a 1994 report in the Journalof
the American Medical Association, the Pentagon's effort to reassure Persian
Gulf veterans seems to have "created a candy store for conspiracy buffs. "Among
the persistent rumors surrounding GWS are stories of 2,000 concealed deaths
among Gulf veterans, mass burials of contaminated Iraqi bodies, the release of
a Russian chemical called Novachok, mysterious deaths of camels and goats in
the desert, exposure to depleted uranium, the use of soldiers as guinea pigs
for unauthorized drugs or vaccines, and widespread burning of soldiers' medical
records.37 Meanwhile, thousands of men and women who could be helped by
psychotherapy are instead encouraged to pursue endless tests and medical exams;
they tend not to see psychotherapists even when their stories make clear that
anxiety, fear, and anger are among their symptoms.

Studies have shown that "very substantial proportions of Vietnam veterans with
readjustment problems" have never sought help from mental health specialists.
Ignorance of therapy, fear of stigma, ideas about masculine self-sufficiency,
and lack of information were the main reasons veterans did not seek help. "By
far the most frequently reported reason....was the hope or belief that the
individual could solve the problem on his own.... Other major reasons ... were
feeling as though treatment would not help, not knowing where to get help,
distrust of mental health professionals, the respondent's fear of what he might
learn from consulting a mental health professional, and the time and cost
involved in seeking treatment."38 Education could have changed the way veterans
perceived themselves and allowed them to seek care without feeling diminished
as men. We do not want the same ignorance and misinformation to persist for
Gulf War veterans.

We owe our war veterans a serious debt, but continuing to deny the validity of
war neurosis is not the way to pay it. The suffering of Gulf War syndrome is
real by any measure, and the symptoms caused by war
neurosis are just as painful and incapacitating as those caused by chemicals,
parasites, or smoke. But until we can acknowledge that even strong and heroic
men and women, fighting in a just cause, can be affected by the conversion of
strong emotions into physical symptoms, no double-blind tests or expensive
studies will change the likelihood that
veterans of even the greatest military victories will continue to become
sick.

As charges of sinister conspiracy and high-level government cover-up
move in to displace and supplant the medical debate, Gulf War Syndrome
becomes an epidemic of suspicion, a plague of paranoia that threatens a
greater
malaise than even Vietnam.

1. David France, "The Families Who Are Dying for Our Country," Red
book, September 1994, 117.